An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored. A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure. Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The current research aims to evaluate liquidity (as an independent variable) to improve the bank’s profitability (as a dependent variable ), by the bank’s ability to maximize its profits from its business results without excessive bank’s liquidity, so that may affect negatively affects the bank’s reputation and it’s dealers confidence in facing their financial obligations. and this may lead trying to come out among other recommendations including contributing to obtain, the bank’s ability to achieve liquidity balance to maximize its profits. This research has been applied to the sample induced intentionally by choosing three Iraqi private banks. The researcher used financial indicators to assess the bank’s liq
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Nutrient enrichment of Sawa lake water was made using different nitrogen and phosphorus concentrations during autumn and spring at three stations. Different concentrations of nitrogen, phosphorus and N: P ratios were used to test variations in phytoplankton population dynamics. Nitrogen at a concentration of 25 µmole.l-1 and N: P ratio of 10:1 gave highest phytoplankton cell number at all stations and seasons. A total of 64 algal taxa dominated by Bacillariophyceae followed by Cyanophyceae and Chlorophyceae were identified. The values of Shannon index of diversity were more than one in the studied stations.
The principle of citizenship has international dimensions that affect the application of the principle, such as the structure of the international system, and the control of the concepts of globalization, international organizations which played an important role in the consolidation of this principle.
The problem of the study revolves around the effects of international variables on the principle of citizenship in Kuwait during the period 1991-2018.
The study used several indicators, such as: the rule of law, achieving the principle of separation of powers, the right to form parties, the application of the law of nationality, and racial discrimination, women's rights, and freedom of expression.
The magnetic properties of a pure Nickel metal and Nickel-Zinc-Manganese ferrites having the chemical formula Ni0.1(Zn0.4Mn0.6)0.9Fe2O4 were studied. The phase formation and crystal structure was studied by using x-ray diffraction which confirmed the formation of pure single spinel cubic phase with space group (Fd3m) in the ferrite. The samples microstructure was studied with scanning electron microstructure and EDX. The magnetic properties of the ferrite and nickel metal were characterized by using a laboratory setup with a magnetic field in the range from 0-500 G. The ferrite showed perfect soft spinel phase behavior while the nickel sample showed higher magnetic loss an
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Many societies have some sports that play a pivotal role in enhancing human physical strength and martial arts and preserving religious values and beliefs. The most prominent of these traditional heroic sports are Zurkhaneh and Sumo, two sports that have their historical origins in the Iranian and Japanese cultural heritage. The research aims at shed light on the historical origins, symbolic rituals, and traditional elements of the sports of Zurkhaneh and Sumo, and to highlight the distinctive characteristics of the sports of Zurkhaneh and Sumo through objective analysis and comparison. The methodology used in this research is the historical approach, using the method of comparative analysis. This method includes analyzing information deriv
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Abstract
Due to the momentum of winning in the streets of the city of Baghdad as a result of the large number of checkpoints so felt researcher to conduct a field visit to find out the main reasons that led to this congestion and to find practical solutions to mitigate wastage winning the arrival time citizen to where you want the least possible time.
This research aims to overcome the difficulties experienced by citizens to reach their places of work and reduce waste at the time of service and waiting time as well as reduce the cost of waiting.
Has emerged study a set of conclusions, including the use of model queue (G / G / C) and the mome
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Grammatical particles are so important in understanding a text and its meaning in linguistic context. This paper " Grammatical Behavior and Uses of Negative and Prohibitive Particles in Semitic Languages: A Comparative Semitic Study"
tackles a very important topic in Semitic languages. Comparative studies in Semitic languages shed light on phenomena in different languages that are related or have one common origin. No doubt, such studies have their own effects on language study in general especially when studying a specific phenomenon and explaining it by reliance on the one origin, or by investigating the various phases of its historical development.
... Show MoreThe present study aims to detect CTX-M-type ESBL from Escherichia coli clinical isolates and to analyze their antibotic susceptibility patterns. One hundred of E. coli isolates were collected from different clinical samples from a tertiary hospital. ESBL positivity was determined by the disk diffusion method. PCR used for amplification of CTX-M-type ESBL produced by E. coli. Out of 100 E. coli isolates, twenty-four isolates (24%) were ESBL-producers. E. coli isolated from pus was the most frequent clinical specimen that produced ESBL (41.66%) followed by urine (34.21%), respiratory (22.23%), and blood (19.05%). After PCR amplification of these 24 isolates, 10 (41.66%) isolates were found to possess CTX-M genes. The CTX-M type ESBL
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Abstract The main purpose of the research is to clarify and investigate in details about Susan Glaspell’s role in shedding light on the predicament of women in American society in the early twentieth century showing how sense of the place played an important role in limiting the opportunities of female protagonists who try to escape the roles imposed upon them by society. Glaspell lived in the early twentieth century in the Midwest and tackled the important issues like: women's suffrage, birth control, socialism, union organizing when women were not able to vote or sit as a member on juries. Her Feminist cause is quite obvious through her works from her first one act play Suppressed Desire to the final three act play, Alison’s House. Th
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